Lecture 1 – Introduction to new public health
Lecture overview
- Health is a social issue
- What is health?
- What is public health?
o New public health
o Importance of evidence
Health is a social issue
“A toxic combination of bad policies, economics and politics is, in large measure, responsible
for the fact that a majority of people in the world do not enjoy the good health that is
biologically possible.” ~ Commission of Social Determinants of Health (WHO), 2008
Social determinants of health
“Conditions in which people are born, live, work and age” e.g., Marmot et al. (2012)
,What is health?
- Clockwork model in medicine:
‘Health is when the body operates efficiently, like a machine’
- More than absence of illness
‘Health is a state of complete physical, mental and social well-being and not merely
the absence of disease ore infirmity’ ~ WHO (1948)
- Positive health
o Strengths that contribute to good health and protect against illness
o Physical, mental, spiritual aspects
o Daily functioning, social participation
o Quality of life
What is public health?
- Health of populations rather than individuals
o Holistic / ecosystems understanding
- Prevention approach rather than treatment
o Protecting groups of people
- Collective rather than personal interventions
o Focus on places, settings, locations
Roots of public health
- Combatting infectious diseases
- Collective health measures throughout history (e.g. 19th century UK public health
reforms)
What influences public health?
, - McKeown’s thesis (1979): improved living standards more important than medical
advances
WHO Healthy Cities approach
- Physical and social environments
- Strong community; citizen participation
- Focus on such outcomes as number of trusting people; availability of community
spaces
New perspectives on public health
- Equity takes center stage (“health for all”)
- All-encompassing: all sectors and all policies should play their role in promoting
health
- Importance of citizen participation and involvement
- New public health ~ health promotion
The Ottawa Charter
, Contributing to a better world
Importance of evidence
- ‘Often people jump to solutions without analyzing the problems to be addressed
fully’ ~ Baum (2016, p.231)
Two main issues for research
- Causes of, and contributors to, health
o Individual, social, structural factors
o Biology, behaviour, support, environment, policy, economy
- Effectiveness of policies and interventions
o Which approaches effectively influence underlying factors?
o Individual, social, structural approaches to change
→ Hands-on experience in the group assignment